Meningococcal B Vaccine Timing for a 10-Month-Old
There is no upper limit for the time between doses of meningococcal B vaccine for a 10-month-old child. However, it is critical to understand that meningococcal B vaccines are not routinely recommended for infants under 10 years of age unless they have specific high-risk conditions.
Key Clinical Context
Meningococcal B vaccines (MenB-FHbp and MenB-4C) are only licensed and recommended for persons aged ≥10 years in the United States. 1 The ACIP guidelines explicitly state "No recommendations for use of MenB vaccines in this population" for children aged 2-23 months and 2-9 years, even in high-risk groups such as those with asplenia or complement deficiencies. 1
If This Child Has Already Started a MenB Series
If a 10-month-old has somehow received a first dose of MenB vaccine (which would be off-label), the following principles apply based on the licensed schedules for older children:
Minimum Intervals (No Maximum)
- The minimum interval between any 2 doses of MenB vaccine is 4 weeks. 1
- There is no specified maximum interval between doses in any ACIP guideline or FDA labeling. 1, 2
Product-Specific Schedules (for ≥10 years)
- MenB-FHbp (Trumenba): For high-risk persons, 3 doses at 0,1-2, and 6 months; if the second dose is given ≥6 months after the first, a third dose is not needed. 1
- MenB-4C (Bexsero): For high-risk persons, 3 doses at 0,1-2, and 6 months; for healthy adolescents, 2 doses at 0 and 6 months. 2
Critical Caveat
The two MenB vaccine products are not interchangeable; the same product must be used for all doses in a series. 1, 2
What You Should Actually Be Considering
If this 10-month-old has high-risk conditions (complement deficiency, asplenia, sickle cell disease), they should be receiving MenACWY vaccines, not MenB vaccines. 1, 3
For high-risk infants:
- MenACWY-CRM is the preferred vaccine starting at 2 months of age as a 4-dose series at 2,4,6, and 12 months. 1, 3
- If started at 7-23 months, give 2 doses with the second dose ≥12 weeks after the first and after the first birthday. 1, 3
Practical Recommendation
If a 10-month-old has received a first dose of MenB vaccine, complete the series according to the licensed schedule once the child reaches 10 years of age, as there is no maximum interval. The vaccine series does not need to be restarted regardless of the delay. 1 However, verify that this child truly needs MenB vaccination rather than MenACWY vaccination based on their risk factors and age. 1, 3